AERB X-Ray Equipment
AERB X-Ray Equipment
AERB X-Ray Equipment
1)
Administrative Officer
Atomic Energy Regulatory Board
Niyamak Bhavan
Anushaktinagar
Mumbai - 400 094.
FOREWORD
The first "Safety Code for Medical Diagnostic X-ray Equipment and Installations,
AERB/SC/MED-2" was issued by AERB in December 1986. This Code has been
revised by a task group (Task Group II) constituted by AERB. The revised Safety
Code for "Medical Diagnostic X-ray Equipment and Installations" has considered
all changes in the recommendations of ICRP and has incorporated all the latest
regulatory requirements relevant to medical X-ray diagnostic practice.
The Standing Committee for Review and Revision of AERB's Radiation Safety
Documents constituted by Chairman, AERB has undertaken the scrutiny and
i
finalisation of this Code. The revised Code, approved for issuance on October
5, 2001 by the Atomic Energy Regulatory Board, is effective from its date of
approval, and replaces the earlier Code dated December 30, 1986.
AERB wishes to thank all individuals and organisations for help in the revision
of the Code. The names of individuals who participated in the preparation of both
the first Code and its present revision are listed for information, along with their
affiliations.
(Suhas P. Sukhatme)
Chairman, AERB
ii
DEFINITIONS
Attenuation
Beam Hardening
A device used for limiting the size and shape of the primary radiation beam.
Commissioning
Competent Authority
Decommissioning
The process by which a facility is finally taken out of operation in a manner that
provides adequate protection to the health and safety of the workers, the public
and the environment.`
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Dose
Dosimetry
Effective Dose
E = Σ WT .HT
T
where HT is the equivalent dose in tissue T and WT is the tissue weighting factor
for tissue T. The unit of effective dose is joule per kilogram (J.kg-1), termed sievert
(Sv).
Equivalent Dose
where DT,R is the absorbed dose delivered by radiation type R averaged over
a tissue or organ T, and WR is the radiation weighting factor for radiation type
R. When the radiation field is composed of different radiation types with different
values of WR, the equivalent dose is defined as:
HT = Σ DT,R .WR .
R
The unit of equivalent dose is joule per kilogram (J.kg-1), termed sievert (Sv).
iv
Employer
Filter
Fluoroscopic Screen
A plastic base upon which a layer of fluorescent material is evenly spread and
which emits visible radiation on being subjected to X-rays;
Gantry Aperture
The physical opening in the CT scanner through which the patient is moved for
the X-ray examination.
Grid
Handle
v
Kerma
K = dEtr /dm
where, dEtr is the sum of the initial kinetic energies of all charged ionising particles
liberated by uncharged ionising particles in a material of mass dm. The SI unit
of kerma is the joule per kilogram (J.kg-1), termed gray (Gy).
Lead Equivalence
Leakage Radiation
Any radiation coming out of the source/tube housing, except the useful beam
or primary beam.
The mechanism to collimate and indicate the radiation field by optical means.
Milliampere-seconds (mAs)
The product of the current through X-ray tube in mA and the duration of the
exposure in seconds.
Quality Assurance
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Radiation
Gamma rays, X-rays or rays consisting of alpha particles, beta particles, neutrons,
protons and other nuclear subatomic particles, but not sound or radiowaves, or
visible, infrared, ultraviolet light.
Any person who is so designated by the employer and who, in the opinion of
the competent authority, is qualified to discharge the functions outlined in the
Radiation Protection Rules, 1971.
Safety
Tube Housing
Type Approval
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Useful Beam or Primary Beam
That part of the emergent radiation from an X-ray tube housing which is capable
of being used for the purpose for which the X-ray equipment is intended.
Worker
Note: Words and expression not defined in this Code, but defined in the Act, Rules and
Surveillance Procedures shall have meanings respectively assigned to them in the Act, Rules
and Surveillance Procedures.
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SPECIAL DEFINITIOINS
Cone
Detector
A device element of a detector unit or array which receives X-rays and responds
by producing an electrical or light signal. The entire assembly of X-ray receiver
may contain a single element of a detector or an array of detectors.
Focus
That area of the anode in an X-ray tube on which X-ray-producing electrons are
incident.
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represents the true spatial frequencies with an object at each spatial frequency.
The maximum value of the modulation transfer function is 1.0. The curve
"function" indicates the degree of accuracy of "transfer" of the modulation (spatial
frequency) from an object to the image at different spatial frequencies within the
image.
Milliampere (mA)
A measure of the electric current through X-ray tube (also called tube current).
Noise
Permanent Filter
See "filter".
Person
Person includes:
x
Scan Incrementation
The movement of the patient couch to a different slice level during a computed
tomography (CT) examination.
Signal-to-Noise Ratio
The ratio of strength of the signal for information content in the image-to-noise
level.
The integrated assembly consisting of X-ray tube along with its housing,
supporting structures, associated accessories necessary for proper operation, and
inclusive of built-in radiation safety devices.
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CONTENTS
FOREWORD ............................................................................................... i
DEFINITIONS.............................................................................................. iii
1. INTRODUCTION ............................................................................. 1
BIBLIOGRAPHY .......................................................................................... 49
1.1 Purpose
(a) ensure that radiation workers and members of the public are not
exposed to radiation in excess of limits specified by the competent
authority under the Radiation Protection Rules, 1971, and by
safety directives issued from time to time;
(b) reduce radiation exposures below these limits to levels as low as
reasonably achievable;
(c) ensure availability of appropriate equipment, personnel and
expertise for safe use of the equipment and for patient protection;
and
(d) ensure timely detection and prompt rectification of radiation
safety-related defects or malfunctioning of the equipment.
1.2 Scope
1
2. SAFETY SPECIFICATIONS FOR MEDICAL
DIAGNOSTIC X-RAY EQUIPMENT AND
PROTECTIVE DEVICES
Tube housing for stationary and mobile diagnostic X-ray units shall be
provided with light beam collimators. These collimators shall comply with
the leakage radiation level prescribed for tube housing.
(a) The minimum total filtration in useful beam for maximum rated
operating tube potential shall be as given in the following table:
2
(b) Total filtration shall be indicated on the tube housing. The total
permanent filtration in the tube shall be not less than 1.5 mm Al.
X-ray unit shall have facilities for tube positioning, target-to-film distance
selection, useful beam centring and angulation, positioning of the patient
and the X-ray film for exposure in the desired manner, and appropriate
features to display the same.
Tube housing and tube support shall have appropriate locking devices
to immobilise the tube in the desired location and orientation.
X-ray table shall have provisions for correct positioning of the grid, the
bucky tray and the film cassette in proper alignment with the useful beam
and for their locking in the desired position.
3
2.1.9 Common Station
When more than one tube can be operated from a single control panel,
there shall be indication at or near the tube housing and on the control
panel showing which of the tubes is being operated.
(a) Dental X-ray assemblies for use with intra-oral films shall be
provided with dental cones ensuring the minimum focal spot
to skin (FSD) distance as given in the following table:
4
TABLE: MINIMUM FOCAL SPOT TO SKIN DISTANCES FOR
DENTAL X-RAY ASSEMBLIES
Maximum rated tube potential (kVp) Minimum focus-to-skin distance (cm)
Between 50 and 60 10
Above 60 and up to and including 75 20
Above 75 30
(a) X-ray tube shall be provided with such cones that will limit the
beam diameter to less than 7.5 cm at the distance specified at
the cone end. Interchangeable cones with built-in diaphragm
shall be marked with the diameter of cross-section of the useful
beam at FSD. The cone shall provide the same degree of
protective shielding as specified for leakage from housing in 2.1.1.
(b) In case of OPG, the protective shielding to attenuate the
transmitted radiation shall form an integral part of the equipment.
Control panel shall be provided with means to indicate and control the
exposure parameters such as tube potential (kVp), tube current (mA),
and beam “ON” and “OFF”.
5
2.3 Mammography X-Ray Equipment
The total filtration in the useful beam shall be not less than 0.03 mm of
molybdenum for screen-film mammography for Mo-W alloy target type
and 0.5 mm of aluminium for xeromammography for W-target X-ray tubes.
If an edge filter is used, the attenuation equivalent shall be given for
the low energy side of absorption edge. The total permanent filter and
attenuation equivalent shall be indicated on the tube housing.
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2.3.5 Locking Devices
7
compression shall be smoothly adjustable and shall remain at the set level
during exposure. The compression plate shall not attenuate the beam by
more than 2 mm tissue equivalent material.
Means shall be provided to ensure that the beam axis will be perpendicular
to the plane of the screen and pass through the centre of screen.
8
2.4.6 Tube Positioning
Sub-section 2.1.10 shall apply. Further, a back-up or safety timer shall also
be provided to safeguard against failure of the phototimer. There shall
also be a visual/aural indicator device to alert the operator in case
phototimer fails to terminate the exposure.
9
2.5.2 Beam-Limiting Devices
Tube housing shall be provided with filter for both beam-hardening and
beam-flattening (bow-tie filter).
The deviation of indicated scan increment from actual scan increment shall
not exceed ± 0.5 mm with a weight of 100 kg simulating a human body
on the patient couch.
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2.5.8 Gantry Aperture Clearance
Gantry aperture clearance at the extremes of tilt shall permit the scanning
of at least a 50 cm thick patient.
2.5.11 Timers
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2.5.12 Warm-up Conditions
Protective lead glass covering of the fluorescent screen shall have a lead
equivalent thickness of 2.0 mm for units operating up to 100 kVp. For
units operating at higher kilovoltages the lead equivalence shall be
increased at the rate of 0.01 mm per kVp.
12
2.6.4 Tube-Screen Alignment
X-ray tube and fluoroscopic screen shall be rigidly coupled and aligned
so that both move together synchronously and the X-ray beam axis
passes through the centre of the screen in all positions of the tube and
screen.
The unit shall have a cumulative timer and its maximum range shall not
exceed 5 minutes. There shall also be provision for an audible signal at
the end of the pre-set time.
The air kerma rate measured at table top for the minimum focus-to-table
top distance shall be as low as possible, and in any case shall not exceed
5 cGy per min.
13
2.6.10 Control Panel
X-ray tube and collimating system shall be so linked with the image
receptor assembly that the beam is centred on the image receptor
assembly. The beam shall be confined within the useful receptor area
at all source-image receptor distances.
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2.7.6 Focus-to-Skin Distance
When the X-ray tube is permanently located under a table, the table shall
be provided with a bucky slot closure having lead equivalence of 0.5 mm
to attenuate all scattered radiation originating under the table.
The kerma rate, measured in air at the position where the centre of the
useful beam enters the patient, shall be less than 5 cGy per min for units
without automatic brightness control (ABC) and less than 10 cGy per min
for units with ABC.
The length and width of X-ray field in the plane of the image receptor
shall not exceed the corresponding distances of the image receptor by
more than 3% of source-to-image distance (SID). The sum of excess
length and width shall be not greater than 4% of SID.
15
(lp) per mm at a modulation transfer function value of 0.1.
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2.9.5 Gonad Shield
The cassette pass box intended for installation in the X-ray room wall
shall have a shielding of 2.0 mm lead equivalence. The design shall be
such that the pass box can be opened from one side at a time.
The box intended for temporary storage of undeveloped films shall have
not less than 2.0 mm lead equivalence all around.
X-ray units installed in a mobile van or vehicle, e.g. for medical surveys/
clinics in remote areas, shall be provided with an appropriate shielding
enclosure to ensure adequate built-in protection for persons likely to be
present in and around the vehicle.
2.9.10 Markings
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2.9.11 Immobilisation
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3. ROOM LAYOUT FOR AN X-RAY INSTALLATION
3.2 Layout
The layout of rooms in an X-ray installation shall be such that the number
of doors for entry to the X-ray rooms shall be kept to the minimum. The
unit shall be so located that it shall not be possible to direct the primary
X-ray beam towards dark room, door, windows, and control panel, or areas
of high occupancy.
The room housing an X-ray unit shall be not less than 18 m2 for general
purpose radiography and conventional fluoroscopy equipment. The size
of room housing the gantry of the CT unit shall not be less than 25 m2.
Also, not more than one unit of any type shall be installed in the same
room, and no single dimension of these X-ray rooms shall be less than
4 m.
3.4 Shielding
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workers and the members of public are kept to the minimum and shall
not exceed the respective annual effective doses as prescribed by the
competent authority. Appropriate shielding shall also be provided for the
dark room to ensure that the undeveloped X-ray films are not exposed
to more than 10 µGy per week. The important dose limits are given in
Appendix-I.
20
is in use to warn persons not connected with the particular examination
from entering the room. An appropriate warning placard as indicated in
Appendix-II shall also be posted outside the X-ray room.
The dark room shall be located adjacent to the X-ray room such that no
primary or secondary X-rays reach inside the dark room.
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4. RADIATION PROTECTION AND WORK PRACTICE
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protect the public in the vicinity. Minimum occupancy and maximum
distance from occupied areas and temporary shields shall be employed
for the purpose. Fluoroscopy shall not be carried out with mobile
equipment.
To ensure minimum possible dose to the patient, the field size shall be
restricted to the minimum that is consistent with the diagnostic
requirement. Particular attention shall be paid to restricting field size in
paediatric radiology. Gonads, unless required, shall not be exposed to
primary beam.
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5. PERSONNEL REQUIREMENTS AND
RESPONSIBILITIES
5.1 Requirements
5.1.2 Radiologist
All installations having more than two X-ray units, or even a single
X-ray unit with fluoroscopy facility, and all establishments performing
special procedures, shall have the services of a qualified radiologist. The
qualifications and experience shall be as given in Appendix-III.
5.2 Responsibilities
5.2.1 Manufacturer
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and maintenance facilities during the useful life-time of X-ray equipment.
In case of CT, the manufacturer shall provide the required phantoms for
dosimetry and image quality checks.
5.2.3 Employer
(b) The employer shall ensure that persons handling medical X-ray
diagnostic equipment duly abide by the provisions of this Code.
In so doing they should obtain technical guidance from various
guides issued by the competent authority from time to time. He/
she shall also ensure that these documents are made available
to them. Further, the employer shall also implement any other
measures of safety as the competent authority may stipulate at
any time in each individual case, without delay.
5.2.4 Radiologist
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achieve maximum reduction in radiation dose to the patient while retaining
all clinically important information.
5.2.6 Student/Trainee
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6. REGULATORY CONTROLS
Every medical diagnostic X-ray equipment shall meet the design safety
specifications stipulated in this Code. The manufacturer/vendor shall
obtain design certification from the competent authority prior to
manufacturing the X-ray equipment.
27
6.5 Commissioning of X-ray Equipment
Only persons holding a valid certificate from the competent authority shall
undertake servicing of X-ray equipment. Certification shall be granted
on the basis of qualifications, training, experience, and safety record of
such person and availability of servicing facilities. Format of application
for obtaining approval of service engineers is given in Appendix-VII.
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6.10 Penalties
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APPENDIX-I
DOSE LIMITS
Workers
1. The cumulative effective dose over a block of five years shall not exceed
100 mSv.
2. The effective dose in any calendar year during a five-year block shall
not exceed 30 mSv.
3. (a) The equivalent dose in any calendar year to the lens of the eye
shall not exceed 150 mSv;
(b) The equivalent dose in any calendar year to the skin, the hands
and feet shall not exceed 500 mSv.
Trainees
The effective dose in any calendar year shall not exceed 6 mSv.
Public
1. The effective dose in any calendar year shall not exceed 1 mSv.
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APPENDIX-II
31
APPENDIX-III
1. Radiologist
2. X-ray Technologist
A certification from the competent authority to the effect that the RSO
designate is capable of fulfilling the duties and functions of an RSO as
laid down in this Code.
4. Service Engineer
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APPENDIX-IV
Government of India
Atomic Energy Regulatory Board
Niyamak Bhavan, Anushaktinagar,
Mumbai-400094.
Separate form should be submitted for each type of medical diagnostic X-ray equipment
A. Details of applicant
1. (a) Name and address of the applicant/local supplier with PIN code (in block letters):
Fax
Telex
Telegram
33
2. (a) Name and address of the manufacturer with PIN code:
Fax
Telex
Telegram
Type approval/NOC
34
B. Details of equipment specification
(a) Kilovolt :
(b) Milliampere :
(c) Exposure time (in seconds) :
1. Name of manufacturer :
2. Type/Model - S.No. :
35
9. Number of focal spots, focal spot size : One/two
and location (specify the accuracy of the Small :............mm × .........mm
marking on the tube housing) Large :............mm × .........mm
Accuracy :........... mm
10. Inherent filtration provided in mm and :
material used
D. Details of generator
1. Nominal voltage :
36
5. Filtration provided
(a) Inherent/permanent filtration : .................. mm Al
37
7. Automatic exposure termination device : Yes/No
1. Screen size :
I certify that all the information furnished by me is correct to the best of my knowledge and belief.
Place : Signature :
Date : Name :
Designation :
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APPENDIX-V
Government of India
Atomic Energy Regulatory Board
Niyamak Bhavan, Anushaktinagar
Mumbai-400094.
39
5. Details of the X-ray unit to be commissioned:
(ii) Make :
1
2
3
4
5
7. The layout plan (scale 1:50) showing the location of X-ray unit, chest stand, doors,
control panel, mobile protective barrier, windows, ventilation, waiting areas and type
of occupancy around including above ceiling and below floor is enclosed. The thickness
of walls and distances of doors, control panel and windows from the X-ray machine/
chest stand are also indicated.
Place: Signature :
Date: Name :
Designation :
40
APPENDIX-VI
Government of India
Atomic Energy Regulatory Board
Niyamak Bhavan, Anushaktinagar,
Mumbai-400094.
To be submitted by the applicant to the Chairman, Atomic Energy Regulatory Board, Niyamak
Bhavan, Anushaktinagar, Mumbai-400094 with a copy to the Head, Radiological Physics and
Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar,
Mumbai-400094. The application for renewal of nomination should be submitted at least
two months prior to the expiry of approval
1. Name and address of the institution with PIN code (in block letters):
2. Name, designation and address of the head of the institution (the applicant) with PIN
code (in block letters):
2. Mode of communication:
Fax
Telex
Telegram
41
4. This application is for:
* Please indicate R for Radiography, F for Fluoroscopy, C for Combined, D for Dental, CT for Computed Tomography,
M for Mammography, Any others (specify)
6. Details of unusual occurrences that have taken place in the past including any radiation
emergencies:
S.No. incident Radiation equip- Details of Number of Maximum dose received
ment or source Nature of action persons by an individual as a
Date of incident
involved taken involved result of the incident
42
Part-2: Particulars Of The RSO-designate
Residential address:
43
4. Academic qualifications and training in radiation safety:
2.
Training course
in radiation 1.
safety
2.
6. Radiation equipment/radioactive materials (if any in the institution) for which RSO will be
responsible:
Radiation Equipment
Radioactive Material
44
8. In case the application is for renewal of nomination of RSO, give details of functions and
responsibilities handled by the RSO since his approval. (Include functions such as tests and safety
checks, training of radiation workers in the institution, reporting on safety status and unusual
occurrences to AERB and RP&AD, BARC and any other functions relating to radiation safety
in the institution)
9. (a) I hereby certify that the information furnished above is correct to the best of my
knowledge and belief;
(b) I undertake to abide by the conditions stipulated by the competent authority from time
to time and follow guidelines in discharging the duties and responsibilities as RSO; and
(c) I further undertake to inform the Atomic Energy Regulatory Board immediately in case
I am relieved of my services as RSO.
10. (a) I hereby certify that all statements made in this application are correct to the best of
my knowledge and belief;
(b) I hereby undertake to provide all necessary facilities to RSO to discharge his/her duties
and functions effectively; and
(c) I further undertake to inform the Atomic Energy Regulatory Board immediately in case
the RSO is relieved of his duties.
45
APPENDIX-VII
Government of India
Atomic Energy Regulatory Board
Niyamak Bhavan, Anushaktinagar
Mumbai-400094.
To be submitted by the applicant to the Chairman, Atomic Energy Regulatory Board, Niyamak
Bhavan, Anushaktinagar, Mumbai-400094 with a copy to the Head, Radiological Physics and
Advisory Division, Bhabha Atomic Research Centre, CT&CRS Building, Anushaktinagar,
Mumbai-400094. The application for renewal of approval of service engineer should be
submitted at least two months prior to the expiry of the approval
1. Name and address of the institution with PIN code (in block letters):
2. Name, designation and address of the Service Engineer with PIN code (in block letters):
3. Date of birth:
4. Mode of communication:
Fax
Telex
Telegram
46
5. This application is for:
Name of institution where the Type of X-ray Nature of job Exposure received
work was done unit serviced carried out (during each job)
47
9. I undertake to abide by the conditions stipulated by the competent authority from time
to time and follow the guidelines in carrying out the service of X-ray machines.
10. (a) I hereby certify that all statements made in the application are correct to the
best of my knowledge;
(c) I further undertake to inform AERB immediately in case the service engineer leaves
the job.
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BIBLIOGRAPHY
49
LIST OF PARTICIPANTS
50
TASK GROUP II
51
STANDING COMMITTEE FOR REVIEW AND REVISION
OF AERB'S RADIATION SAFETY DOCUMENTS (SCRCG)
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